Smokers can quit before they're ready, VA study says

Current medical wisdom holds that doctors should wait until smokers are ready to quit, and then blanket them with counseling, medicine and support.

But research out of the Minneapolis VA Medical Center suggests that doctors are waiting too long.

Offering a quit-smoking program of telephone counseling to 1,500 veterans, researchers found success with those prepared to kick the habit — but also with those who were merely thinking about it.

Among veterans who were ready to quit, 13 percent stopped smoking in six months, even without help, the study found. Among those who received counseling, the quit rate was 21 percent.

But the headline finding was in veterans who weren't ready to quit, but were "contemplating" the idea. Without support, 6.5 percent quit smoking in six months. With the counseling, 11 percent quit.

In an era of limited medical resources, waiting until smokers are ready might seem like a good option because it reduces wasted spending on failed attempts.

But that's not how the rest of the medical world operates, and now there is data to back up a more aggressive approach, said Dr. Elisheva Danan, the lead author of the Minneapolis VA study.

"We don't do that with any other illness," she said. "We don't ask diabetics, 'Are you ready to treat your diabetes?' "

The study also tried counseling on smokers who weren't thinking about quitting at all, and the results weren't as impressive. Only 5 percent of those "precontemplation" veterans who received counseling weren't smoking six months later. And that wasn't any better than the rate of those veterans who quit without the study's help.

Still, Danan said it was impressive that many of these smokers who had no interest in quitting agreed to try the counseling.

Whether the approach would work for the broader U.S. population is unclear. But Danan said the results warrant a more aggressive strategy.

"Almost half of the smokers in our study who quit said they weren't planning to quit at baseline," she said. "If we hadn't reached out to them, if we hadn't offered treatment, we would have missed out on an opportunity to help those people."